Cath Lab Digest - January 2008 - (Page 38)

38 YOUR PATH TO SUCCESS: CAREER ADVICE JANUARY 2008 continued from previous page Q A What were your findings? Were any of the conclusions surprising? The purpose of this study was to determine whether there was an increase in the rates of either MI or death associated with DES compared to BMS over the long-term, out to two years. We were surprised to find that there was not a difference. In fact, there was actually a reduction in the rates of death and MI with DES compared to BMS. We also found that the rates of restenosis were reduced — similar to what we have seen with the randomized trials — and maintained out to two years. The other conclusion that was reassuring was that over the entire two-year period the benefit that we saw was consistent, without any crossing of the event curves to suggest a tradeoff in risks over time. Can you comment on the use of dual antiplatelet therapy during the time periods covered by this analysis? The time period that we looked at coincided with the introduction of DES in April 2003. At that time, the recommendations for dual-antiplatelet therapy were to use aspirin indefinitely and clopidogrel for three months for sirolimus-eluting stents and for six months for paclitaxel-eluting stents. This is important to place this study in context, as these recommendations are shorter than what the current DES guidelines suggest, which is 12 months. Has your involvement with this project and its findings changed your views of DES or BMS safety? I am reassured that this study demonstrated that there is not an adverse effect associated with drug-eluting stents. Before we did this study, I still had concerns regarding whether the randomized trials were large enough to detect an increase in the rate of mortality or MI. But after having conducted this study of almost 11,000 matched patients and being surprised to find lower rates of death and MI in these DES patients, I am reassured that these stents appear to be safe — at least out to two years of follow up. What are your plans going forward in regards to this database? There are several interesting questions going forward. As I mentioned, all patients who received a DES or BMS were eligible for this registry and many patients treated in our study were high risk because of either comorbid conditions or their acute presentation. It is difficult to know how to best treat these patients, as they are not usually included in randomized trials. I think the Massachusetts data might be really helpful to see if the safety of DES holds up in higher risk groups. I also think it will be important to continue to follow these patients beyond two years to see if the findings are consistent. Sponsored and prepared by Boston Scientific Corporation Q A technology, training and staffing. Do you know who on your staff is involved with organizations? If you have staff members that hold a position with local or even national organizations, work with them to share their knowledge and experience with the rest of your team. They could present information at staff meetings or even post the information in the lounge for staff members to read during breaks. You will be surprised how much local information these organizations share and discuss, from new regulations to what is going on at other facilities. National Conferences Many of the professional societies previously mentioned have national educational conferences. In terms of educational benefit and raising the standard of the profession, these venues are phenomenal. The opportunity to network and interact with other professionals as well as witness live, real-time case reviews and even view tissue in the specimen lab is an incredible learning experience. Unfortunately, these can be costly when travel and other factors are considered. In terms of who goes where, Corazon recommends the same process we use when discussing educational opportunities with our clients. First, research the venues and locations of the major and specialized conferences that will be beneficial to attend. Then, plot out which ones make the most sense for which staff, including travel burden, scheduling, personal preference, etc. Once one or two staff members are selected to attend each conference, charge them with writing a white paper, creating a poster board presentation, or presenting a full in-service on the key things that they learned. This not only ensures active participation by the attendees, but also keeps all of the staff in the loop of what is new and cutting-edge in our industry. Q A licensure, these programs have blossomed to include trauma, critical care, and other certifications as well as general education topics. Although this type of learning does take away from the “group” and “team” interaction, it allows significant flexibility in terms of scheduling and completion. Staff can even access these programs at home, forgoing a drive to the hospital for an “education day.” To insure standardization and the achievement of core competency goals, Corazon recommends that departments set up a small committee to outline learning objectives for the coming year, approve online curriculum (including obtaining approval from any hospital-wide education department and arranging for payment), and to develop timelines and tracking mechanisms. Although the internet offers a great wealth of programs, facilities must insure that content is appropriate and universal for all staff. Vendor Education Vendors can provide a wealth of knowledge to your staff. Most device and drug representatives welcome the opportunity to speak with you and your staff about their products and services. They can also provide written material to distribute to your staff to read at a later time. Keeping up with technology takes time and effort. By bringing this information to the team, you will let them know that you are committed to their education and development. Focusing on new technology opportunities can be particularly helpful if your facility is planning to expand or grow your program in the near future. If you don’t know the latest technologies, your physicians certainly do. They are keeping up with the latest trends in cath labs as well as what new graduates are learning and using in their training programs. A new graduate fresh out of training is looking for state-of-the-art technology and devices. If you are expanding or growing your program, new technology — and staff who are comfortable with its use — will be keys to success. Q A Once one or two staff members are selected to attend each conference, charge them with writing a white paper, creating a poster board presentation, or presenting a full in-service on the key things that they learned. This not only ensures active participation by the attendees, but also keeps all of the staff in the loop of what is new and cutting-edge in our industry. Internet Another rapidly growing venue for staff education is the internet. Many companies have initiated online staff education programs to improve skill competency, critical thinking ability, and overall pathophysiology. Originally initiated to assist nurses and other licensed professionals in meeting their continuing education requirement for state Your Market and Your Competition Stay one step ahead of the game by keeping up with market trends and your competition. If you have no competition, then you are lucky — but chances are you do. More and

Table of Contents Feed for the Digital Edition of Cath Lab Digest - January 2008

Cath Lab Digest - January 2008 Central Baptist Hospital Contrast Media Use in High-Risk Patients An Ergonomic Survey of Cath Lab Repetitive Stress Injuries Contents Clinical Editor’s Corner Takotsubo Cardiomyopathy, a.k.a., Transient Left Ventricular Apical Ballooning Syndrome: An Acute Coronary Syndrome Imposter Searching for the Key to D2B STEMI Intervention News STEMI Interventions: Commentary The Massachusetts Stent Study The Value of Educating Staff Ask the Clinical Instructor: A Q&A Column for Those New to the Cath Lab SICP* Chapter Updates The Society of Invasive Cardiovascular Professionals Holds an RCIS Review Course at New Cardiovascular Horizons 18:20 To Denver — One Student’s First Clinical Experience CEU Education Center Meetings Calendar What Do You Think? Clinical & Industry News Classifieds The Ten-Minute Interview with…Heather Vardon, RN Advertisers Index

Cath Lab Digest - January 2008

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